在三级儿科心脏治疗机构分娩的产前诊断先天性心脏病婴儿的结局

Outcomes of Infants with Prenatally Diagnosed Congenital Heart Disease Delivered in a Tertiary-care Pediatric Cardiac Facility.

作者信息

Changlani Trupti Deepak, Jose Annu, Sudhakar Abish, Rojal Reshma, Kunjikutty Radhamany, Vaidyanathan Balu

机构信息

Departments of Pediatric Cardiology and *Obstetrics and Gynecology, Amrita Institute of Medical Sciences and Research Centre, AIMS Ponekkara P.O, Kochi, Kerala, India. Correspondence to: Dr Balu Vaidyanathan, Clinical Professor, Pediatric Cardiology, Amrita Institute of Medical Sciences, Kochi, Kerala 682 041, India.

出版信息

Indian Pediatr. 2015 Oct;52(10):852-6. doi: 10.1007/s13312-015-0731-x.

DOI:10.1007/s13312-015-0731-x

PMID:26499008

Abstract

OBJECTIVE

To report short-term outcomes of infants with prenatally diagnosed Congenital Heart Disease (CHD) delivered in a tertiary-care cardiac facility.

DESIGN

Retrospective study.

SETTING

Tertiary-care referral hospital.

PARTICIPANTS

Children with prenatally diagnosed CHDs who underwent delivery at study centre during the period January 2008 - December 2013 were included. Outcomes tracked from hospital records and direct follow-up.

RESULTS

Of the 552 fetuses diagnosed to have CHD, 121 (22%) were delivered at the study centre. Fetuses undergoing a planned delivery were diagnosed in late gestation (mean gestational age 31.5 ± 5.1 wk). 74 fetuses (61.2%) had simple CHD and rest were complex. 96 (79.3%) neonates received cardiac care; 30 (24.8%) required surgery while 5 received catheter-based interventions. 11 patients underwent surgery on follow-up. Neonatal survival in cardiac care group was 93.8%; on follow-up (12.5 ± 13.1 mo); 83 (86.4%) of these infants were alive. All infants undergoing neonatal surgery or catheter-based interventions survived. 25 patients (20.6%) received comfort care (Complex CHD, associated co-morbidities); 14 (56%) survived neonatal period and 6 (24%) were alive on follow-up.

CONCLUSIONS

Infants with prenatal diagnosis of CHD and planned delivery in a cardiac facility had satisfactory immediate outcomes, expecially in those receiving specialized post-natal cardiac care.

摘要

目的

报告在三级心脏护理机构分娩的产前诊断为先天性心脏病（CHD）的婴儿的短期结局。

设计

回顾性研究。

地点

三级护理转诊医院。

参与者

纳入2008年1月至2013年12月期间在研究中心分娩的产前诊断为CHD的儿童。从医院记录和直接随访中追踪结局。

结果

在552例被诊断患有CHD的胎儿中，121例（22%）在研究中心分娩。计划分娩的胎儿在妊娠晚期被诊断（平均孕周31.5±5.1周）。74例胎儿（61.2%）患有简单CHD，其余为复杂CHD。96例（79.3%）新生儿接受了心脏护理；30例（24.8%）需要手术，5例接受了导管介入治疗。11例患者在随访中接受了手术。心脏护理组的新生儿存活率为93.8%；在随访中（12.5±13.1个月）；这些婴儿中有83例（86.4%）存活。所有接受新生儿手术或导管介入治疗的婴儿均存活。25例患者（20.6%）接受了舒适护理（复杂CHD，合并其他疾病）；14例（56%）存活至新生儿期，6例（24%）在随访中存活。